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Ask The Nurse: Selinexor

In this month’s blog, we have decided to tell you about a new anti-myeloma drug called selinexor.

Ask The Nurse // 31st July 2019

We find that some patients and family members like to know about the latest myeloma research. Therefore, we are often asked about clinical trials which are currently recruiting in the UK and the types of new treatments being developed for myeloma.

These queries are more common when patients are assessing their future treatment options, are considering taking part in a clinical trial or when a new treatment has been in the news.

A drug called selinexor (Xpovio®) is one of the latest drugs to show promise for the treatment of myeloma and was recently in the news after the Food and Drug Association (FDA) in the US approved it in combination with dexamethasone for the treatment of myeloma patients who have received at least four previous treatments.

In this month’s blog, we have decided to tell you more about selinexor and how it works.

What is selinexor?

Selinexor is a new drug called a selective inhibitor of nuclear export (SINE) which is being investigated in several combinations for the treatment of myeloma. Selinexor works in an entirely different way from other anti-myeloma drugs and could, therefore, provide a treatment option for patients who have relapsed multiple times or do not respond (refractory) to currently available anti-myeloma drugs.

How does it work?

Selinexor stops a protein called Exportin 1 (XPO1) from working properly. XPO1 is a protein responsible for moving other proteins between different parts of the cell. Myeloma cells exploit XPO1 to get rid of proteins, called tumour suppressor proteins, which would stop them growing and multiplying. By blocking XPO1, the tumour suppressor proteins build up within the myeloma cells, killing myeloma cells.

Why was selinexor approved for use by the FDA?

The combination of selinexor and dexamethasone was approved for use in myeloma patients who have previously received at least four myeloma treatments and were refractory to several currently available treatments. This decision was taken based on results from early phase clinical trials which indicated that combining selinexor and dexamethasone was an effective treatment for some heavily pre-treated myeloma patients. However, there were some concerns about the observed side effects of selinexor. The approval by the FDA in the US is a conditional approval which will be reassessed when the results of a large phase 3 study are available. Several other clinical trials in the US are evaluating the safety and effectiveness of different selinexor combination treatments. These trials aim to find ways to improve the effectiveness and safety of selinexor.

Is selinexor available in the UK?

Selinexor is not routinely available for myeloma patients in the UK and is only accessible to patients as part of a clinical trial.

There is only one clinical trial in the UK investigating selinexor, MUK twelve. The trial is evaluating the benefit selinexor in combination with cyclophosphamide and prednisolone for the treatment of relapsed/refractory myeloma.  The trial is only open to patients who have previously received two or more lines of treatment.

For more information download the “Selinexor Horizons Infosheet”. You can also find out more about myeloma clinical trials recruiting in the UK by checking our “Myeloma Trial Finder” or about anti-myeloma drugs by looking at our “Myeloma Drug Tracker”.

Best Wishes

The Myeloma Information Specialist Team